Impact of Visual Stimulation Therapy in the Management of Cerebral Visual Impairment in Paediatric Cerebral Palsy

Authors

  • Inês Figueiredo Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal http://orcid.org/0000-0002-6037-2768
  • Andreia Ramos Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal
  • Marisa Carmo Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal
  • Inês Martins Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal
  • Luís Almeida Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal
  • Catarina Silva Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal
  • Joaquim Murta Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
  • Catarina Paiva Department of Ophthalmology, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal; Associação de Paralisia Cerebral de Coimbra (APCC), Coimbra, Portugal

DOI:

https://doi.org/10.48560/rspo.33245

Keywords:

Cerebral Palsy, Photic Stimulation, Vision Disorders, Vision, Low

Abstract

INTRODUCTION: Cerebral visual impairment (CVI) is a common yet underdiagnosed cause of visual dysfunction in paediatric cerebral palsy (CP) for which there is not an approved therapy available. The aim of our study was to present our experience in CVI management in paediatric CP subjects involved in a visual stimulation therapy (VST) program.
METHODS: A group of paediatric CP patients with severe CVI was selected and submitted to a VST program between February 2022 and September 2023. Median number of VST sessions was 1 per week, conducted over an average follow-up period of 12 months. Visual Assessment Scale - Cerebral Visual Impairment in persons with Profound Intellectual and Multiple Disabilities (VAS CVI-PIMD) was applied for standardized and objective assessment of two parameters: 1) visual functioning level (VFL), and 2) total characteristics of CVI. Assessment was conducted by the same multidisciplinary team of occupational therapists and an ophthalmologist. VAS CVI-PIMD was re-measured after the intervention period to evaluate the effect of VST in the VFL, characteristics, and severity of CVI. A questionnaire was also administered to parents. A related samples Wilcoxon Signed Rank test was used to compare initial pre-VST scores with post-VST scores. p-values <0.05 were considered statistically significative.
RESULTS: Eight children with CP and severe CVI (age range, 1 - 14 years) were selected. Initial median VFL was 3, corresponding to an exogenous attention system. After the VST program, 7/8 subjects improved at least one level, reaching a median VFL of 4 corresponding to a basic recognition and active visual attention system (p=0.014). Total number of CVI characteristics in each patient decreased from a median score of 9 on the initial evaluation to a median score of 6 after the follow up period (p=0.013). Parent questionnaire revealed a perception of improvement in eye-hand coordination skills and social functioning in everyday life.
CONCLUSION: In the present cohort, visual rehabilitation with appropriate stimuli for each stage of visual development leads to measurable gains in the visual performance of children with CVI.

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Published

2024-09-28

How to Cite

Figueiredo, I., Ramos, A. ., Carmo, M. ., Martins, I. ., Almeida, L. ., Silva, C., … Paiva, C. . (2024). Impact of Visual Stimulation Therapy in the Management of Cerebral Visual Impairment in Paediatric Cerebral Palsy. Revista Sociedade Portuguesa De Oftalmologia, 48(3), 172–181. https://doi.org/10.48560/rspo.33245

Issue

Vol. 48 No. 3 (2024)

Section

Original Article

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